A former alcoholic who feels shame about past drinking may be at greater risk for relapsing and developing other health problems, according to researchers at the University of British Columbia.

The findings reveal that behavioral displays of shame strongly predict whether recovering alcoholics will relapse in the future.

Past research has suggested that experiencing shame can motivate people to improve their self-image and contribute to the greater good. However, it was unclear if general improvement affects specific behaviors.

For example, it’s unclear if experiencing shame about a DUI actually deters drinking and driving. In fact, some research has suggested that shame does more harm than good, as it can contribute to hiding, escape, and general avoidance of the problem.

Psychological scientists Jessica Tracy, Ph.D., and doctoral student Daniel Randles of the University of British Columbia wanted to know if the distinction between shame and guilt might play an important role in determining future behavior.

For example, those who feel shame may blame themselves for negative events and view their “bad” behavior as an unchangeable part of who they are. Therefore, shame may actually be a risk factor for certain behaviors rather than a deterrent. But this doesn’t seem to be the case for guilt.

“One reason that certain sobriety programs may be effective,” the researchers say, “is because they encourage people to see their behaviors as something they should feel guilty, but not necessarily shameful, about.”

Feeling guilt toward previous choices, as opposed to feeling shame about being a “bad” person, may be a vital part of recovery.

To investigate the influence of shame and guilt on recovery from addiction, the researchers looked at drinking and health outcomes in a sample of newly sober recovering alcoholics.

Shame is difficult to gauge because people often avoid acknowledging feelings of shame. To account for this, the researchers used measures of self-reported shame and shame-related behaviors, such as a narrowed chest and slumped shoulders. The researchers believed that participants would be less able to voluntarily control these ‘behavioral’ displays of shame.

In the first session, participants were asked to “describe the last time you drank and felt badly about it.” The researchers video-recorded their responses. In another session about four months later, participants were asked to report their drinking behaviors. The participants completed questionnaires about their physical and mental health at both of the sessions.

The findings revealed that people who displayed more shame-related behavior were likely to be in poorer physical health at the time of the first session.

Furthermore, behavioral displays of shame predicted whether participants would relapse after the first session.

“How much shame participants displayed strongly predicted not only whether they relapsed, but how bad that relapse was — that is, how many drinks they had if they did relapse,” said Tracy and Randles.

Shame behaviors during the first session also predicted distressing psychiatric symptoms at the second session. And the results show a possible association between shame and worsening health over time.

In contrast, self-reported shame did not predict likelihood of relapse, number of drinks consumed, or health outcomes, giving further proof that a self-report may not be an accurate way to measure shame.

“Treatment providers have long suspected that shame is a barrier to recovery, but this is the first time we’ve seen this link evidenced so robustly,” note Tracy and Randles.

“Our research suggests that shaming people for difficult-to-curb behaviors may be exactly the wrong approach to take,” Tracy and Randles said. “Rather than prevent future occurrences of such behaviors, shaming may lead to an increase in these behaviors.”